PURPOSE: This study was to develop Web-based multimedia content for Physical Examination and Health Assesment. METHOD: The multimedia content was developed based on Jung's teaching and learning structure plan model, using the following 5 processes : 1) Analysis Stage, 2) Planning Stage, 3) Storyboard Framing and Production Stage, 4) Program Operation Stage, and 5) Final Evaluation Stage. RESULTS: The web based multimedia content consisted of an intro movie, main page and sub pages. On the main page, there were 6 menu bars that consisted of Announcement center, Information of professors, Lecture guide, Cyber lecture, Q&A, and Data centers, and a site map which introduced 15 week lectures. In the operation of web based multimedia content, HTML, JavaScript, Flash, and multimedia technology(Audio and Video) were utilized and the content consisted of text content, interactive content, animation, and audio & video. Consultation with the experts in context, computer engineering, and educational technology was utilized in the development of these processes. CONCLUSIONS: Web-based multimedia content is expected to offer individualized and tailored learning opportunities to maximize and facilitate the effectiveness of the teaching and learning process. Therefore, multimedia content should be utilized concurrently with the lecture in the Physical Examination and Health Assesment classes as a vital teaching aid to make up for the weakness of the face-to- face teaching-learning method.
*Computer-Assisted Instruction ; *Education, Nursing ; *Health Status ; Humans ; *Internet ; *Multimedia ; *Nursing Assessment ; *Physical Examination

PURPOSE: This study was to test the effectiveness of Web-based multimedia contents for Physical Examination and Health Assessment on learning achievement. METHOD: Multimedia contents based on Jung's teaching and learning structure model were used to enhance learning achievement. Learning achievement was measured by the knowledge of Physical Examination and Health Assessment. The participants of this study were students in a BSN and RN-BSN program in a university located in Seoul. 59 students in the experimental group received lectures using web-based multimedia contents and 75 students in the control group received regular lectures. RESULTS: The mean score of the degree of educational achievement in the experimental group(mean=31.09) was significantly higher than in the control group(mean=25.55)(t=-3.883, p=.000). CONCLUSION: These web-based multimedia contents were found to maximizethe effectiveness of the teaching process when used as a teaching aid, and yet kept the strength of a face to face teaching learning method. This program is recommended as part of a main text, vital teaching aid or cyber lecture materials in nursing schools and in health care educational institutions.
Physical Examination/*nursing ; *Nursing Assessment ; *Multimedia ; Korea ; *Internet ; Humans ; Health Status ; *Education, Nursing ; *Computer-Assisted Instruction ; Adult

BACKGROUND AND OBJECTIVES: Recent data about trans-radial approach showed its usefulness in achieving the high procedural success rate and low local complications even though the size of the radial artery is small compared to that of the femoral artery. Therefore, we want to evaluate the size of the radial artery and the feasibility of the trans-radial coronary angiography as a routine technique. MATERIALS AND METHOD: Trans-radial coronary angiography (TRCA) was successful in 619 cases. The size of the radial artery was measured using 2D-ultrasonography. TRCA was tried with 4 Fr catheters. We divided the cases into two groups; early phase, 106 cases and late phase, 513 cases and compared the procedure time, catheter number used, and complications between 2 groups. RESULTS: The size of the radial artery was 2.7+/-0.4 mm in diameter and this of the men was larger than that of women (p 0.05). TRCA was performed successfully in 513 cases among 521 cases of late phase (98.5%) and crossover to femoral artery occurred in 8 cases (1.5%). The fluoroscopic time and total procedure time of the late phase (6.5+/-4.0 min, 22.9+/-11.3 min) were significantly lower than those of early phase (11.5+/-6.3 min, 31.2+/-13.7 min) (p<0.01). The average number of catheters used for coronary angiography was 1.8+/-1.0. There were 6 cases (1%) of radial artery occlusion and 1 case (0.2%) of radial artery perforation without hand ischemia. CONCLUSION: Based on the adequate size of the radial artery, high success rate and low complications, TRCA might be a safe and become a routine diagnostic technique.
Catheters ; Coronary Angiography* ; Female ; Femoral Artery ; Gangwon-do* ; Hand ; Humans ; Ischemia ; Male ; Radial Artery

The medical records of inpatients with diagnoses of either ICD-9 193(malignant neoplasm of the thyroid gland) or 226(benign neoplasm of the thyroid gland) in the claims sent in by medical care institutions throughout the country, to the Korea Medical Insurance Corporation (KMIC) during the period from January 1, 1986 to December 31, 1987 were abstracted. These records were abstracted in order to identify and confirm new cases of thyroid cancer among the beneficiaries of the KMIC. Using these data, the incidence rate of thyroid cancer among Koreans was estimated as of July 1, 1986 through June 30, 1987. The crude rates were estimated to be 0.76(95% Cl: 0.63-0.87) and 3.87(95% Cl: 3.60-4.14) per 100,000 in males and females, respectively, and the cumulative rates for the age spans 0-64 and 0-74 in males were 0.06% and 1.10%, respectively. In females, those were equally 0.35%. The age-adjusted rate for the world population was 0.93 per 100,000 in males, which is one of the lowest levels in the world. However, the adjusted rate in females was 3.96 per 100,000, which is an average level and very similar to that of the Chinese in Singapore and Shanghai. A similar tendency was shown in the case of the truncated rates for the age group of 35-64, which was 1.91 per 100,000 in males and 8.82 per 100,000 in females.
Adolescent ; Adult ; Age Factors ; Aged ; Epidemiologic Factors ; Female ; Humans ; Korea/epidemiology ; Male ; Middle Aged ; Sex Factors ; Thyroid Neoplasms/*epidemiology/pathology

OBJECTIVES: This study investigated the effects of chronic medical diseases on depressive symptoms in individuals at high risk for depression living in rural areas, over a 1-year period.METHODS: A community-based longitudinal study was conducted; 67 participants aged 18–79 years residing in rural areas were included. In the first survey, all participants completed a self-report questionnaire battery. An interview was also conducted to obtain data on demographic variables and current or past chronic medical diseases. In the first survey, participants with the Center for Epidemiologic Studies Depression scale(CES-D) scores of 16 or higher were categorized as being at high risk for depression; the same assessments were carried out 1 year later in a follow-up survey. Multiple regression analysis was performed to determine the association of chronic medical diseases with 1-year follow-up depressive symptoms in the high-risk group.RESULTS: In model 1, which controlled for sociodemographic variables, the number of chronic medical diseases (p =0.026), baseline severity of depressive symptoms(p =0.002), and presence of diabetes(p =0.039) were significantly associated with the follow-up CES-D scores. In model 2, which further adjusted for Alcohol Use Disorder Identification Test and Beck Anxiety Inventory scores, the number of chronic medical diseases(p =0.036), baseline severity of depressive symptoms(p =0.017), and prevalence of diabetes(p =0.037) were also significantly associated with the follow-up CES-D scores.CONCLUSION: This study suggests that the number of chronic medical diseases, prevalence of diabetes, and severity of depressive symptoms are significantly associated with 1-year follow-up depressive symptoms in individuals at high risk for depression.
Anxiety ; Depression ; Diabetes Mellitus ; Epidemiologic Studies ; Follow-Up Studies ; Longitudinal Studies ; Prevalence ; Rural Population

Background: Hodgkin's lymphoma (HL) constitutes 10%–20% of all malignant lymphomas and has a high cure rate (5-year survival, around 90%). Recently, interest has increased concerning preventing secondary complications (secondary cancer, endocrine disorders) in long-term survivors. We aimed to study the epidemiologic features and therapeutic outcomes of HL in children, adolescents, and young adults in Korea. Methods: We performed a multicenter, retrospective study of 224 patients aged < 25 years diagnosed with HL at 22 participating institutes in Korea from January 2007 to August 2016. Results: A higher percentage of males was diagnosed at a younger age. Nodular sclerosis histopathological HL subtype was most common, followed by mixed cellularity subtype.Eighty-one (36.2%), 101 (45.1%), and 42 (18.8%) patients were classified into low, intermediate, and high-risk groups, respectively. Doxorubicin, bleomycin, vinblastine, dacarbazine was the most common protocol (n = 102, 45.5%). Event-free survival rate was 86.0% ± 2.4%, while five-year overall survival (OS) rate was 96.1% ± 1.4%: 98.7% ± 1.3%, 97.7% ± 1.6%, and 86.5% ± 5.6% in the low, intermediate, and high-risk groups, respectively (P = 0.021). Five-year OS was worse in patients with B-symptoms, stage IV disease, highrisk, splenic involvement, extra-nodal lymphoma, and elevated lactate dehydrogenase level.In multivariate analysis, B-symptoms and extra-nodal involvement were prognostic factors for poor OS. Late complications of endocrine disorders and secondary malignancy were observed in 17 and 6 patients, respectively. Conclusion This is the first study on the epidemiology and treatment outcomes of HL in children, adolescents, and young adults in Korea. Future prospective studies are indicated to develop therapies that minimize treatment toxicity while maximizing cure rates in children, adolescents, and young adults with HL.

BACKGROUND: The aim of this study was to investigate the prevalence, clinical and laboratory findings of hereditary hemolytic anemia (HHA) in Korea from 1997 to 2006 and to develop the appropriate diagnostic approach for HHA. METHODS: By the use of questionnaires, information on the clinical and laboratory findings ofHHA diagnosed from 1997 to 2006 in Korea was collected and analyzed retrospectively. A total of 431 cases were enrolled in this study from 46 departments of 35 hospitals. RESULTS: The overall frequency of HHA did not change through the 10-year period for pediatrics but did show an increasing tendency for internal medicine. The overall male to female sex ratio did not show sex predominance (1.17:1), but a significant male predominance with a ratio of 1.49:1 was seen for pediatrics while a significant female predominance with a ratio of 1:1.97 was seen forinternal medicine. Of the total cases, 74.2% (282/431) were diagnosed before the age of 15 years. The etiologies of HHA were classified as red cell membrane defects, hemoglobinopathies, red cell enzyme deficiencies and unknown causes. There were 382 cases (88.6%) of red cell membrane defects with 376 cases (87.2%) of hereditary spherocytosis and 6 cases (1.4%) of hereditary elliptocytosis, 20 cases (4.6%) of hemoglobinopathies with 18 cases (4.2%) of beta-thalassemia, a case (0.2%) of alpha-thalassemia and a case (0.2%) of Hemoglobin Madrid, 7 cases (1.6%) of red cell enzyme deficiencies with 5 cases (1.2%) of glucose-6- phosphate dehydrogenase (G-6-PD) deficiency, a case (0.2%) of pyruvate kinase (PK) deficiency and a case (0.2%) of enolase deficiency, and 22 cases (5.1%) of unknown causes. The most common chief complaint in pediatric patients was pallor and that in adult patients was jaundice. In the red cell membrane defect group of patients, the level of hemoglobin was significantly higher than in adult patients. The mean corpuscular volume, mean corpuscular hemoglobin, corrected reticulocyte count, total and indirect bilirubin level and lactate dehydrogenase levels in the hemoglobinopathy group of patients were significantly lower than the values in the red cell membrane defect group of patients. The mean concentration of G-6-PD was 0.8+/-0.7U/1012RBC in the G-6-PD deficient patients, PK was 1.7U/1010 RBC in the PK deficient patient, and the level of enolase was 0.04U/g of Hb in the enolase deficient patient. CONCLUSION: The most prevalent cause of HHA in Korea during 1997 to 2006 was hereditary spherocytosis, but HHA by other causes such as hemoglobinopathy and red cell enzyme deficiency gradually increased with the development of molecular diagnostic methods and increasing general interest. However, the etiologies of HHA need to be pursued further in 5.1% of the patients. An systematic standard diagnostic approach is needed in a nationwide prospective study for correct diagnoses and appropriate management of HHA.
Adult ; alpha-Thalassemia ; Anemia, Hemolytic, Congenital* ; beta-Thalassemia ; Bilirubin ; Cell Membrane ; Diagnosis ; Elliptocytosis, Hereditary ; Erythrocyte Indices ; Female ; Hemoglobinopathies ; Humans ; Internal Medicine ; Jaundice ; Korea* ; L-Lactate Dehydrogenase ; Male ; Oxidoreductases ; Pallor ; Pathology, Molecular ; Pediatrics ; Phosphopyruvate Hydratase ; Prevalence ; Pyruvate Kinase ; Reticulocyte Count ; Retrospective Studies* ; Sex Ratio ; Surveys and Questionnaires